Eye Rejuvenation

Dr. Roy Geronemus.

by Delia von Neuschatz

The area underneath my eyes had been bothering me for a while as with the march of time, it was starting to look a bit hollow. I had done some research and knew that injecting fillers in the tear troughs could improve the look of the area, but for me, putting a syringe close to my eyes was a scary proposition! Still, I had seen good results with fillers on a friend or two and was considering the option. Then, I looked into laser treatments and in the process learned that they could also brighten the under-eye area in more ways than one.

While I was contemplating the idea of fillers, I went to see Dr. Roy Geronemus to eliminate some broken capillaries on my cheeks. He pointed out the visible blue veins underneath my eyes and said that he could remove those with a laser too. Ditto for the larger veins around my temples. I had noticed those blood vessels but they never bothered me much as I thought they were pretty common. Well, of course, after they were brought to my attention, that’s all I could see when I looked into the mirror. But still, I held off. Would removing these veins affect the blood flow to the eyes? Even though Dr. Geronemus and two other dermatologists assured me it would have no detrimental effect on circulation, it took me a few months to screw up the courage to submit to a laser.

Before and After photos of laser treatments for the removal of blood vessels in the eye area. The pulses of light delivered by the laser cause the blood within the vein to coagulate, eventually destroying the vessel which is later reabsorbed by the body. Blood then flows through the deeper veins just as it did before the surface veins developed. Lasers can also be used to eliminate blood vessels on the upper eyelids along with redness, a common side effect of blepharoplasty. A fortunate and not uncommon side effect of laser treatment to the under-eye area is neocollagenesis or the synthesis of new collagen resulting in thicker, brighter, less crepey skin.

The treatment was not entirely painless, but it was quick. A pair of metal ocular shields were placed directly on my eyeballs to shield them from the Excel V laser. This was not something I expected and after they were plucked off at the end of the procedure, my eyes felt raw and sensitive. If you wear contact lenses, I highly recommend that you leave them at home and just wear your glasses for this treatment. As for pain, underneath my eyes, there was just a stinging sensation at the point of contact with the laser.

The elimination of the larger veins on my temples was more painful however. No topical anesthetic was applied as this constricts the vessels, making it more difficult to treat. All in all, the procedure lasted a brief 10 to 15 minutes. Costs range between $450 - $750 depending on the extent of the treatment.

The ocular shields placed on the eyes prior to laser procedures.

Afterwards, the under-eye area was a bit red and swollen for a couple of days, as expected. A small scab had formed which worried me somewhat as Dr. Geronemus cautioned that there is a very small risk of scarring. But, this too went away without a trace in a few days, helped by the application of Aquaphor. The blue veins had disappeared almost immediately and I was pleased with the fast results. A follow up visit may be necessary depending on the number and size of veins.

In my case, a couple of visible blood vessels remained so a month later, I returned for a second visit. An unexpected and very pleasing side effect was that, by the time of my second treatment, the skin underneath my eyes looked smoother, thicker and thus lighter. Dr. Geronemus confirmed that this is not an uncommon side effect because when thermal energy is delivered into the dermis, as it is with lasers, you get neocollagenesis or the formation of new collagen. Should new veins pop up underneath my eyes, I will certainly have them treated with a laser if only for the collagen-boosting results!

Dr. David Orentreich.

Next up were fillers. I had decided to take the plunge, pleased as I was with the results of the laser treatment. The fillers typically used in the under-eye area are hyaluronic acids such as Restylane, Juvederm and Belotero.

The hollow grooves located on top of the orbital bone are referred to as the tear troughs because tears roll down this track. Although there are no dermal fillers that are FDA-approved for the tear trough, fillers are used off-label in this area.

Made of a natural sugar that’s in your skin, hyaluronic acids give a soft correction to facial hollows.

Effects last approximately six months after the first treatment, but can last even longer after subsequent treatments. I opted for Belotero as the skin under the eyes is thin and Belotero is the thinnest of the hyaluronic fillers. Costs range between $700 - $850 depending on the product used.

The hollow grooves located on top of the orbital bone are referred to as the tear troughs because tears roll down this track. Although there are no dermal fillers that are FDA-approved for the tear trough, fillers are used off-label in this area.

Injecting the tear troughs with a dermal filler.

Injecting the eye area is not without risks. Too much filler results in lumpiness. And if the filler blocks a retinal artery, it can cause blindness.Dr. David Orentreich is the experienced dermatologist I turned to for this procedure. After the area was numbed with a topical analgesic cream containing Lidocaine, he injected a small amount of Belotero in the tear trough, patting it down as he went along. I had a bit of swelling and redness (but no bruising) afterwards which lasted for a day or two. A week later, Dr. Orentreich manually smoothed out some residual unevenness. Injecting the under-eye area with filler has not only reduced the hollowness, but it has also plumped up some of the wrinkles, reducing the existing crepiness.

Before and After photos of tear trough filler treatment.

As a result of the laser treatments and fillers, the skin underneath my eyes looks lighter, brighter and smoother and I will not hesitate to repeat these procedures as the need arises.

Not ready or willing to take lasers or needles to your under-eye area? The beauty experts at NYSD Beauty recommend the following products:

Lavido Alert Eye Cream
The Lavido Alert Eye Cream is an all-natural under-eye cream from Israel that combines plant-based hyaluronic acid, cold pressed avocado oil, organic pomegranate seed oil and citrus extracts with the volcanic thermal springs from the sea of Galilee to brighten and moisturize the skin around the eye area. Clinically proven to increase skin's elasticity and help diminish the appearance of fine lines and wrinkles.

Intitut Esthederm Lift & Repair Eye Contour Lift Patches
If you need a real jolt, try Institut Esthederm Lift & Repair Eye Contour Lift Patches. These five-minute wonders contain caffeine and will tighten and lift the skin under the eye area as well as smooth fine lines and wrinkles. This is Travel Beauty’s founder, Alyssa Barrie’s, favorite eye product. She says your face will immediately brighten up and look younger. She loves the patches for travel, before important meetings and prior to attending gala events. To be used 3 x per week.

Sapelo Restoring Eye Cream
The light formula of Sapelo’s Eye Restoring Cream absorbs right into the skin, boosting collagen production with a blend of powerful peptides, reducing dark circles with botanical burdock and strengthening capillaries with a cocktail of antioxidants.

Expert Tip: Alyssa advises that “when it comes to eye creams, don't be afraid to get in there and massage the cream into the under-eye area. Also remember to sweep up and around to the crow’s feet area — and get in there too!”